HX641 57032 
RC963  .F54  Periodic  physical  ex 


RECAP 


Columbia  ®nitiem'tp 

mtljeOEitpoflimgork 

College  of  3^l)v^\tiani  anb  ^urseon£( 
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Periodic  Physical  Examination  of 

Employes:  Its  Economic 

and  Social  Value 


Address  delivered  before 

The  National  Association  of  Manufacturers 

May  26,  1915 


By  Eugene  Lyman  Fisk,  M.  D. 

Director  of  Hygiene 

LIFE  EXTENSION  INSTITUTE,  Inc. 

25  WEST  45th  STREET 

NEW  YORK 


Issued  by  the 

Life  Extension  Institute 

Incorporated 


To  prolong  life  and  mal^e  it  more  livable 


NBW    YORK,  N.  Y. 

2B     W.     45TH     ST. 


HON.    WM.    H.    TAFT, 

Chairman,  Hoard  nf  Directing 

ELMER    E.    RITTENHOUSE, 

I'rr^idi'nt 

GEN.    W.    C.    GORGAS, 

Covsiilta  nt ,  Sa  ii  itat  ion 

PROF.     IRVING    FISHER, 

Chairman,  Ilytiicnc  Reffrenre  Board 

EUGENE   L.    FISK,    M.D., 

Director  of  Hygiene 

HAROLD   A.    LEY, 

y ire- President  and  Treasurer 
JAMES   D.    LENNEHAN, 

Srrrilitry 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/periodicphysicalOOfisk 


Periodic  Physical   Examination  of  Employes, 
its  Economic  and  Social  Value. 

Address  delivered  before  the  National  Association  of  Manufacturers 
May  26th,   1915, 

Why  should  a  turtle  live  longer  than  a  man  ?  What  does  the 
turtle  contribute  to  the  biological  progress  of  the  universe  that 
he  should  be  granted  three  times  the  span  of  human  life? 

Is  it  not  a  little  galling  to  human  pride  when  we  reflect  that 
man,  supposedly  at  the  center  of  the  universe,  bending  most 
of  its  mighty  forces  to  his  will,  is  yet  unable  to  distance  the 
tortoise  in  the  race  for  longevity? 

It  is  all  very  well  to  say  that  the  life  of  the  turtle  is  flat, 
stale  and  unprofitable.  After  all,  he  lives  long  and  apparently 
comfortably  and  happily — barring  such  accidents  as  getting 
into  our  soup.  Man,  on  the  contrary,  lives  a  brief  existence, 
hampered,  nagged  and  handicapped  by  countless  miseries  and 
disabilities,  that  not  only  shorten  his  existence  but  embitter  it, 
causing  him  as  a  rule  to  break  down  prematurely,  and  })re- 
venting  him  from  achieving  what  mind  and  body  are  capable 
of  achieving  when  working  in  harmony  with  Nature's  laws. 

Man  has  defied  the  forces  of  Nature,  and  harnessed  many 
of  them  in  his  service,  but  concomitantly  he  has  broken  many 
of  the  laws  of  Nature,  creating  an  artificial  environment,  pro- 
tective in  some  respects,  menacing  in  others. 

The  Cjuestion  that  confronts  us  is  tiiis :  Is  it  inevitable  that 
the  higher  and  more  complex  life  of  man  should  be  shorter 
than  the  lower  life  of  the  turtle? 

So  far  as  science  can  reveal,  there  seems  to  be  no  princi]ile 
of  either  life  or  death.  There  are  many  good  and  bad  reasons 
why  men  die,  but  no  un(k'rl\ing  necessary  reason  why  they 
must  die.  The  brilliant  Carrel,  now  working  in  the  very  jaws 
of  death,  has  kci)t  tissue  cells  alive  outside  the  body  for  the 


past  three  years.  These  cells  are  multiplying  and  growing, 
apparently  unchanged  by  time,  to  all  appearances  immortal  so 
long  as  they  are  i)eriodically  washed  of  poison  and  nourished 
in  a  proper  medium.  Wash  man  of  his  poisons  at  intervals,  and 
nourish  him.  and  win-  should  he  not  live  on  so  long  as  there 
is  energy  in  the  universe  to  supply  his  needs. 

Notwithstanding  what  I  have  said  about  the  turtle,  I  would 
not  waste  one  moment  of  time  in  pleading  for  a  mere  extension 
of  human  existence,  if  there  were  not  sound  scientific  evidence 
to  prove  that  such  extension  can  most  easily  be  attained  by 
improving  the  quality  and  the  total  value  of  existence.  There 
is  even  something  ignoble  in  hanging  on  to  the  coat-tails  of 
Old  Father  Time  just  to  sneak  a  few  more  years  of  life. 
Tolstoi  is  right  in  advising  us  not  to  fear  death,  which  under 
present  conditions  like  sleej),  must  come  to  all.  It  is,  rather, 
a  wasted  and  deformed  life  that  we  should  fear  and  that  we 
should  seek  to  escape,  not  by  leaving  it,  but  by  mending  and 
moulding  it. 

Man  has  made  some  progress  in  escaping  death,  and  in 
hammering  down  the  death  rate  as  the  following  figures  show : 

Death  Rate 
Year  per  1,000  living 

Geneva 1551-1600  39.7 

Geneva    1891-1900  17.6 

Berlin  1721-1730  40.6 

Berlin    -.  1 905-1910  15.5 

London   1 800-1810  29 

London    3905-1910  14 

Paris 1809-1816  30.5 

Paris   1905-1910  17.5 

Sweden    1751-1760  27.4 

Sweden    1912  14.2 

U.  S.  Reg.  Area 1880  19.8 

U.  S.  Reg.  Area 1913  14.1 

While  the  average  duration  of  human  life  has  been  greatly 
extended  during  the  past  century,  there  has  been  no  material 
addition  to  the  span  of  human  life.  It  is  true  that  in  certain 
countries  such  as  Sweden,  England  and  Wales,  Prussia  and 
Denmark  there  has  been  a  gain  in  vitality  at  every  age  period 


of  life  during  the  past  quarter  century,  but  in  this  country,  so 
far  as  we  can  determine  from  our  exceedingly  unsatisfactory 
registration  records,  there  has  been  not  only  a  failure  to 
lengthen  the  span  of  life  but  a  positive  loss  in  vitality  at  middle 
life  and  later,  notwithstanding  the  fall  in  the  general  death 
rate. 

This  conquering  of  death,  in  the  earlier  age  periods  of  life 
is  due  to  man's  success  in  meeting  the  massive  frontal  attacks 
of  such  enemies  as  diphtheria,  tuberculosis,  typhoid  fever  and 
diseases  of  infancy.  The  elimination  of  such  plagues  as  "Black 
Death,"  yellow  fever,  smallpox,  has  also  left  its  impress  on 
the  general  death  rate.  But  we  have  been  less  successful  in 
guarding  against  influences,  agencies  and  infections  which  may 
be  compared  to  submarine  attacks,  or  to  sapping  and  mining 
operations  that  reveal  no  enemy  until  an  explosion  occurs. 
Under  this  class  of  agencies  we  include  faulty  living  habits 
which  tend  to  disturb  the  functions  of  the  body  and  impair  the 
efficiency  of  our  organs,  ultimately  causing  them  to  break 
down ;  also  chronic  infections,  which  pass  unnoticed  often  for 
years  until  announced  by  illness  and  physical  failure. 

HUMAN  LIFE  A  STRUGGLE  WITH  GERM  LIFE. 

Life  is  one  long  struggle  with  micro-organisms.  Sanitation, 
quarantine  and  the  annihilation  of  pest  carriers  such  as  the 
mosquito  and  rat,  protect  us  from  some  of  these  enemies,  but 
others  lodge  in  our  tooth  sockets,  our  tonsils,  our  middle  ears, 
the  nasal  cavities,  etc.,  and  from  such  favorable  bases  of  sup- 
plies stream  out  and  attack  our  joints,  our  gall  bladders,  our 
appendices,  our  stomachs,  hearts,  kidneys  and  other  vulner- 
able points. 

A  sound  bodily  condition  protects  against  all  such  menaces, 
as  the  normal  human  body  has  a  war  machine  that  gets  quickly 
and  successfully  into  motion  against  these  minute  enemies. 

But  few  individuals  are  always  in  a  state  of  perfect  health. 
Most  men  have,  at  least  at  intervals,  their  points  of  least 
resistance,  and  few  are  aware  of  these  weak  si)ols  until  a 
successful  attack  reveals  their  presence. 


THE  HUMAN  MACHINE. 

]\Ian  has  often  been  compared  to  a  macliine.  This  may  not 
be  true  of  man  as  a  whole,  but  his  body  is  certainly  built  on 
mechanical  principles.  The  motions  of  his  limbs  are  con- 
trolled by  a  perfect  system  of  levers,  and  he  even  has  shock 
absorbers.  The  heart  is  a  pump  with  valves  constructed  on 
ordinary  mechanical  principles.  The  blood  vessels  are  elastic 
tubes  that  contract  or  dilate  under  the  control  of  nerve  centers 
that  respond,  like  push  buttons,  to  certain  stimuli.  The  entire 
telegraphic  and  telephonic  system  of  this  country  is  not  more 
complex,  and  is  certainly  less  efihcient,  than  the  sensory  and 
motor  nervous  system  linking  the  brain  to  the  body  and  gov- 
erning its  functions. 

jMillions  upon  millions  of  cells — muscle,  nerve,  brain,  kid- 
ney, liver,  heart,  are  all  busily  at  work,  each  with  a  definite 
function  to  perform.  Few  people  who  buy  a  manufactured 
product  stop  to  think  of  how  it  is  made;  how  seldom  their 
imaginations  are  stimulated  to  go  back  of  the  shop  in  which 
the  article  is  sold  and  visualize  the  army  of  toilers  who  bring 
the  article  into  being.  How  few  have  any  knowledge  what- 
ever of  the  marvellous  machinery  that  often  seems  to  be  alive 
and  purposeful  in  the  complexity  and  precision  of  its  move- 
ments. 

To  the  manufacturer,  the  integrity  and  precision  and  the 
smooth  working  of  this  machinery  is  the  first  rule  of  preserva- 
tion in  his  business.  Before  a  manufacturer  can  engage  in 
business,  he  must  plan  and  build  his  machines  and  then  he 
must  test  them.  After  they  are  established  and  in  good  work- 
ing order,  doe's  he  then  sit  back  and  take  their  products  until 
they  break  down?  Such  a  course  would  be  looked  upon  as 
insane.  No  well  managed  plant  but  has  its  system  of  inspec- 
tion. 

But  what  about  the  men  who  guide  and  supervise  these 
machines,  who  sell  their  products  and  who  keep  the  wheels 
of  business  moving?  Is  there  some  good  kind  fairy  that 
watches  for  the  first  signs  of  faulty  heart  pump,  of  an  impaired 
poison  separator  (the  kidneys),  of  poles  and  wires  down  in 
the  telegraph  and  telephone  system  (nerves),  of  hardening  in. 


those  normally  elastic  tubes  (arteries),  and  countless  other 
indications  of  over-stoking,  rust  and  clinkers  in  this  marvel- 
lously complex  human  machine  ? 

In  most  estabhshments  this  task  is  certainly  left  to  the 
fairies,  for  there  is  no  human  agency  that  covers  it.  Wel- 
fare work  and  emergency  medical  relief  for  employes  is  pro- 
vided in  most  of  the  important  industrial  establishments,  and 
many  of  them  require  a  physical  examination  before  employ- 
ment. A  regular,  systematic  periodic  physical  examination 
of  the  entire  body,  such  as  is  applied  to  ordinary  machinery, 
is,  however,  practically  non-existent,  except  in  the  establish- 
ments taking  the  service  of  the  Life  Extension  Institute.  * 

PREVENTION  vs.  CURE. 

Immediate  relief  for  injury  or  illness  is  a  matter  of  com- 
mon humanity,  but  the  prevention  of  illness  and  accident  is  a 
matter  of  business  economy,  as  well  as  humanity.  This  is  well 
recognized  in  regard  to  accidents  by  the  widespread  use  of 
safety  devices.  But  the  almost  infinite  capacity  of  the  human 
machine  for  going  wrong  seems  not  to  be  recognized,  and  the 
remedy  is  usually  applied  only  after  physical  deterioration 
and  impairment  has  resulted  in  frank  illness,  or  in  accident 
that  is  essentially  caused  by  illness.  Long  before  the  heart 
breaks  down,  or  the  kidneys  lose  their  function,  or  the  arteries 
become  seriously  affected,  there  is  a  period  of  slow  change 
which  often  affects  the  efficiency  of  the  individual  and  increases 
the  liability  to  accident.  These  early  signs  of  trouble  are 
readily  revealed  by  thorough  health  examinations,  affording 
the  o])portunity  not  only  to  prevent  disease,  and  accident  due 
to  an  improperly  working  body,  but  to  improve  the  general 


*  I  am  informed  by  Mr.  Royal  S.  Meeker,  United  States  Commissioner 
of  Labor  Statistics,  that  it  is  contemplated  to  establish  a  central 
agency  in  that  Department  for  the  systematic  collection  of  informa- 
tion regarding  welfare  work  among  employes,  to  supply  the  demands 
upon  the  Department  of  Lal)or  for  information  of  this  character. 
It  would  seem  desirable  for  employers,  who  are  making  provision 
for  the  physical  examination  or  care  of  their  employes,  to  submit 
a  precise  statement  to  the  Department  in  order  that  those  who  are 
interested  may  have  a  reliable  source  of  information  on  this  subject. 
The  Institute  will  he  pleased  at  all  times  to  receive  information  of  this 
character. 


average  condition  of  the  individual,  raise  him  to  a  higher  level 
of  physical  fitness,  and  increase  his  capacity  for  living  hap- 
pily, contentedly  and  efficiently. 

All  these  factors  have  an  economic  as  well  as  a  social  and 
humanitarian  value.  An  employee  who  is  sound  and  healthy, 
who  is  doing  work  to  which  he  is  physically  adapted,  is  less 
irrital:>le,  suspicious  and  intractable  than  an  employee  who  is 
physically  below  par  and  easily  stimulated  into  unreasoning 
discontent. 

The  value  of  the  system  of  periodic  examination  is  no  longer 
a  matter  of  theory.  In  one  life  insurance  company  (Postal 
Life),  a  trial  of  this  system  over  a  period  of  five  years  resulted 
in  a  reduction  in  mortality  of  about  50  per  cent,  among  those 
taking  the  examination,  and  a  saving  of  $13  for  every  dollar 
expended. 

The  experience  of  such  corporations  as  the  National  Har- 
vester Co.,  Sears,  Roebuck  and  Co.,  the  National  Cash  Reg- 
ister Co.  and  the  Chicago  and  Northwestern  R.  R.  Co.  and 
others,  where  examinations  of  applicants  for  employment  are 
carried  on,  show  the  need  of  inspecting  the  human  body  that 
is  called  upon  to  do  work.  The  Chicago  and  Northwestern 
report  that  12  per  cent,  of  the  men  examined  were  found 
unfit  for  the  form  of  employment  sought. 

In  Sears,  Roelnick,  through  their  system  of  entrance  exami- 
nation and  medical  inspection  and  examination  of  special 
groups,  the  death  rate  among  those  sufifering  from  tuberculosis 
was  reduced  from  11  to  1  per  cent.,  and  the  percentage  of 
tuberculous  employes  from  4.G  per  cent,  to  .8  of  1  per  cent. 

TITE  TOTAL  VALUE  OF  THE  HEALTH  SURVEY. 

In  all  establishments  of  which  I  have  knowledge,  the  effort 
seems  to  be  to  give  the  employee  work  adapted  to  his  physical 
capacities.  The  mere  weeding  out  of  tuberculous  employes  or 
others  who  are  a  menace  to  their  fellows,  by  reason  of  com- 
municable disease,  is  a  minor  feature  of  the  work.  It  is, 
of  course,  greatly  in  the  interests  of  the  tuberculous  employee 
that  he  be  located  and  aft'orded  an  opportunity  for  seeking 
treatment,  rather  than  that  he  continue  at  work  until  his 
malady  has  perha])s  Ijccome  incuraljlc. 


The  chief  vakie  of  the  system  of  complete  health  surveys, 
supplemented  by  education  in  personal  hygiene  lies  in  its  total 
effect  on  the  force,  and  in  its  power  to  raise  the  general  level 
of  fitness,  well-being  and  efficiency. 

These  are  the  broad  general  purposes  that  actuate  such  men 
as  Ex-President  Taft,  Surgeon  General  Gorgas,  Professor 
Irving  Fisher,  Dr.  Alexander  Graham  Bell  and  other  eminent 
scientific  men  and  publicists  who  have  joined  in  the  work  of 
the  Life  Extension  Institute  without  compensation  or  other 
reward  than  the  satisfaction  of  seeing  these  benefits  extended 
to  the  largest  possible  number  of  people. 

The  privilege  of  periodic  physical  inspection  has  already 
been  extended  to  a  vast  body  of  insurance  policyholders  through 
arrangements  made  by  certain  life  insurance  companies  with 
the  Institute. 

The  latest  company  to  take  this  service,  the  Germania  Life 
of  New  York,  tried  this  experiment  first  in  New  York  City, 
and  the  opportunities  for  improving  the  condition  of  policy- 
holders was  so  manifest  that  the  system  was  quickly  extended 
to  their  policyholders  throughout  the  country. 

No  life  insurance  company  has  any  relation  with  the  Insti- 
tute other  than  that  of  patron.  The  interest  of  the  life  insur- 
ance company  is  similar  to  that  of  the  employer.  By  reducing 
the  number  of  death  claims,  the  company  is  reimbursed  for 
its  expenditure  for  the  Institute's  service.  The  employer  bene- 
fits by  a  reduced  sickness  rate  and  accident  rate  among  his 
employes,  and  an  increase  in  their  mental  and  physical  effi- 
ciency. 

GOOD  WORK  AND  GOOD  BUSINESS. 

To  measure  these  benefits  to  the  employer  accurately  will 
take  years  of  experience,  but  it  must  be  evident  that  an  influ- 
ence that  will  produce  a  50  per  cent,  saving  in  mortality  and 
return  $13  for  every  $1  expended  in  life  insurance  will  at 
least  produce  a  10  per  cent,  improvement  in  the  physical  and 
mental  efficiency  of  empl()}'es. 

There  arc  oilier  c\i)cricnlial  data  that  sujijiort  those  views, 
such   as   the  known   inllucntx'  of   alcoht)!   in   impairing  mental 


and  muscular  efficiency,  the  power  to  memorize,  the  power  to 
perform  a  simple  act  such  as  typewriting,  typesetting,  etc., 
conditions  that  are  paralleled  by  functional  disturbances  and 
diseased  conditions  revealed  by  the  examinations. 

Assuming  the  tigure  to  be  conservative,  it  follows  that  the 
application  of  the  system  to  a  group  of  employes  earning 
$100,000,000  per  annum  would  increase  their  productivity  10 
per  cent.,  and  result  in  a  gain  in  earning  capacity  of  $10,000,000 
per  annum,  provided  the  occupation  were  one  in  which  the 
physical  and  mental  efficiency  could  affect  the  quality  and  the 
quantity  of  the  work  turned  out.  This  does  not  take  into 
account  the  reduced  amount  of  illness,  death  and  accident,  all 
of  which  have  a  tremendous  economic  and  business  value. 
Prolonged  illness  or  death  of  experienced  and  valued  employes 
may  mean  many  thousands  of  dollars  to  a  concern. 

Government  has  already  placed  a  certain  responsibility  on 
the  employer  for  the  care  and  protection  of  his  employes. 
Workmen's  compensation  acts  are  being  passed  by  State  after 
State,  and  common  business  prudence  dictates  that  the  em- 
ployer shall  take  every  reasonable  means  to  limit  his  liability. 

That  the  liability  to  accident  among  a  group  of  employes 
who  are  examined  once  a  year  is  less  than  the  average  cannot 
be  questioned  by  any  reasonable  person. 

Various  considerations  of  policy  and  politics  have  as  yet 
prevented  any  official  and  statutory  recognition  of  this  fact, 
but  the  fact  remains.  Even  where  a  compensation  law  calls 
for  compulsory  insurance  the  employer  need  not  shrug  his 
shoulders  and  say,  "I  am  now  protected  by  my  insurance  pre- 
miums, and  there  is  nothing  further  to  be  done."  With  a 
reduction  in  the  accident  rate,  from  whatever  cause,  there 
must  ultimately  come  about  a  reduction  in  the  cost  of  insur- 
ance. Where  the  employer  carries  the  risk  himself,  the  strong- 
est possible  reason  exists  for  periodic  physical  examination, 
from  which  the  two-fold  benefit  of  increased  efficiency  and 
reduced  accident  loss  will  result. 

Here  is  a  recent  instance  that  came  to  my  notice.  The 
other  day,  in  a  large  wood  pulp  plant  in  Canada,  a  man  was 


10 


lightly  hit  on  the  head  while  at  work,  and  instantly  killed. 
It  was  found  that  he  had  suffered  from  heart  disease,  and  that 
-a  light  shock,  that  would  not  have  put  a  football  player  out 
•of  a  game,  had  sufficed  to  kill.  A  large  indemnity  was  paid 
to  the  widow.  How  much  better  it  would  have  been  for  the 
man,  widow  and  plant,  if  the  man  had  been  examined  and 
kept  out  of  work  that  exposed  him  to  accident  and  injury. 

The  value  of  such  an  influence,  in  reducing  accident  lia- 
bility, is  plainly  implied  in  the  New  York  Law,  which  allows 
under  safety  and  welfare  credits  a  reduction  of  from  1  to  10 
per  cent,  for  such  vague  conditions  as  "competency  of  man- 
agement," "attitude  toward  employes,"  "attitude  toward  acci- 
dent prevention,"  "general  conditions  tending  to  establish  more 
cordial  relations  between  employer  and  employes,"  etc.  If  such 
ill-defined  factors  can  properly  be  given  a  percentage  value, 
the  direct,  systematic  controlling  influence  of  periodic  physical 
inspection,  for  the  purpose  of  detecting  physical  weaknesses 
and  impairments,  many  of  which  predispose  to  accident,  can 
hardly  be  denied  an  equal  value. 

When  we  read  that  12  per  cent,  of  applicants  for  employ- 
ment have  been  found  defective,  or  that  1  to  4  per  cent,  of 
employes  have  been  found  tuberculous,  it  must  not  be  thought 
that  these  even  remotely  express  the  value  of  the  periodic 
-examination,  and  that  there  is  no  influence  on  the  balance  of 
the  force. 

WHAT  THESE  EXAMINATIONS  REVEAL. 

A  consideration  of  the  following  analysis  of  the  examination 
of  employes  made  by  the  Life  Extension  Institute  shows  that 
practically  all  those  examined  ofl'ered  some  opixtrluuity  for 
betterment.  On  the  other  hand,  the  number  that  arc  found 
positively  unfitted  for  any  form  of  cniployiiiciit  is  very  small. 
Yet,  business  prudence,  as  well  as  common  humanity,  renders 
it  a(lvisal)le  to  locate  this  small  percentage  and  to  take  the 
])roper  stejis   for  the  protection  of  all  concerned. 


11 


RESULTS  OF  THE  EXAMINATION   OF  EMPLOYES  OF 

COMMERCIAL  HOUSES,  BANKS,  ETC. 

BY  THE  LIFE  EXTENSION  INSTITUTE,  INC. 

Normal    Ol^^o 

Imperfect — Advice  needed  regarding  physical  condi- 
tion or  living  habits .99% 

Not  aware  of  impairment .81% 

Referred  to  physician  for  treatment .Q7% 

CLASSIFICATION  OF  IMPAIRMENTS. 

Moderate  to  Serious. 

Organic  heart  disease   6.14% 

Arteriosclerosis— thickened  arteries    13.94% 

High  or  low  blood  pressure 26.81% 

Urinary — Albumin,  sugar,  casts 43.27% 

Individuals  showing  combined  disturbance  of  circu- 
lation and  kidneys 17.82% 

Nervous  1.44% 

Lungs — possible  tuberculosis   .49% 

Venereal .41% 

Minor  to  Moderate. 

Functional,  Circulatory — Rapid,  slow  or  intermittent 

pulse   10.51% 

Urinary  (high  and  low  specific  gravity,  crystals,  in- 

dican,  etc. ) 20.58% 

Digestive  Organs 9.73% 

Constipation    20.29% 

Nose  and  throat 30.56% 

Ears    15.38% 

Decayed  teeth  and  infected  gums 26.93% 

Anemia  3.50% 

Skin    7.96% 

Errors  in  diet  (pronounced) 28.54% 

Errors  in  personal  hygiene 56.22% 


12 


Physical  Defects. 

Faulty  vision  (uncorrected) 22.89^ 

Flat  foot  3.09fo 

Faulty  Posture   8.62fo 

Rupture,  no  truss 1.23% 

Overweight,   important    6.10% 

Underweight,  important   18.44% 

Unclassified    13.94% 

The  above  table  shows  the  percentages  that  the  various 
impairments  are  of  the  whole  number  of  employes  examined. 
Many  employes,  of  course,  showed  several  combined  impair- 
ments.   Average  age  30. 

The  life  insurance  experience  is  along  similar  lines,  but 
modified  by  several  conditions :  a  higher  average  age,  the 
purely  voluntary  self  selection  of  each  individual  examined, 
and  the  fact  that  many  of  these  examinations  were  made  in 
remote  sections  by  less  highly  trained  examiners. 

Many  of  the  impairments  above  listed  constitute  serious 
physical  and  mental  handicaps.  They  interfere  with  an  alert, 
snappy,  wideawake  attention  to  business.  They  favor  indif- 
ference, lassitude,  and  inaccuracy  and  increase  the  liability  to 
accidents.  Leaving  out  such  serious  matters  as  diseases  of 
the  heart,  kidney,  blood  vessels,  lungs,  ranging  from  the  incipi- 
ent to  well-defined  stages,  there  is  faulty  vision,  mouth  infec- 
tion, nose  and  throat  affections,  constipation,  flat  foot,  and 
other  so-called  minor  defects,  all  interfering  with  the  proper 
working  of  the  human  machine. 

More  than  90  per  cent,  of  those  sufificieiUly  impaired  lo  be 
referred  to  physicians  for  medical  ircatnient  were  not  aware 
of  any  impairment,  and  were  taking  no  slejis  to  correct  their 
condition. 

All  of  which  goes  to  show  that  tlie  average  individual  is 
usually  far  below  his  attainable  condition  of  health  and  well- 
being. 

About  onc-lialf  of  these  people  showed  some  serious  error 
in  diet  or  personal  hygiene,  the  correction  of  which  would 
undonl)te(ll\-  improxe  their  condition. 

13 


PLANS  AND  METHODS. 

The  method  of  carrying  on  this  work  has  been  carefully 
studied  by  the  Institute,  and  is  standardized  along  certain  lines. 
An  examining  room  is  equipped  by  the  Institute  in  the  estab- 
lishment, and  a  sufficient  number  of  trained  physicians  detailed 
to  rapidly  examine  the  force,  each  doctor  working  a  half 
day  only  in  order  to  keep  the  work  up  to  a  high  grade  of 
accuracy  and  precision. 

This  work  as  designed  by  the  Institute  is  done  very  thor- 
oughly, and  involves  a  complete  health  survey — eyes,  ears, 
nose,  throat,  lungs,  heart,  blood  vessels,  blood  pressure,  urine, 
nervous  system,  physique,  posture,  possible  deformities,  rup- 
ture, flat-foot,  consideration  of  family  history  and  living  habits. 
All  these  data — derived  from  the  personal  statement  of  the 
employee,  the  examiner's  report,  and  the  laboratory  report — 
are  considered  by  trained  diagnosticians,  and  if  no  impairment 
is  found,  the  employee  is  notified.  If  a  slight  impairment 
or  error  in  personal  hygiene — eating,  drinking,  working,  play- 
ing, smoking,  exercise,  etc., — is  found,  he  is  directly  advised, 
and  also  instructed  by  means  of  "Keep-Well"  leaflets  appro- 
priate to  his  case.  Education  in  the  care  of  the  health  is  pro- 
vided Ijy  monthly  "Health  Letters."  If  some  impairment 
requiring  medical  attention  is  found,  the  report  is  sent  to 
the  family  physician  or  to  some  physician  designated  by  the 
employee,  and  he  is  advised  and  urged  by  the  Institute  and 
his  employer  to  seek  the  necessary  treatment,  unless  the  con- 
dition is  one  that  can  be  handled  by  the  company's  physician, 
if  such  there  be. 

Every  effort  is  made  to  protect  the  employee  from  undue 
alarm,  if  impairment  is  found.  In  all  cases  showing  any 
impairment,  the  chief  local  examiner  receives  the  report  from 
the  Home  Office,  and  delivers  them  to  the  employes,  with  such 
suggestions  as  may  properly  be  gi\en  in  regard  to  errors  in 
hygiene,  physical  defects,  or  the  necessary  form  of  medical 
treatment  to  seek.  This  method  guards  against  misunder- 
standing of  the  report,  or  undue  alarm  or  indifference  and 
neglect  on  the  part  of  the  employee !  A  report  is,  of  course, 
rendered  to  the  employer  of  each  case  examined,  and  an  analy- 

14 


sis  is  made  of  the  general  results,  with  such  suggestions  in 
regard  to  the  sanitary  conditions  or  the  condition  of  the  force 
as  may  be  derived  from  the  survey  of  the  plant  and  the  force. 

Every  three  months  certain  cases,  which  seem  to  require  it, 
are  checked  up  in  regard  to  special  conditions,  such  as  blood 
pressure,  urine,  heart,  lungs,  etc.,  in  order  that  the  full  benefit 
of  the  system  may  be  exerted  and  the  progress  of  such  cases 
watched. 

The  Institute  is  willing  to  arrange  for  one  of  the  staff  to 
visit  the  plant  regularly  as  an  emergency  physician,  but  for 
this  special  work  the  employer  must  make  private  arrange- 
ment with  the  physician,  as  the  Institute  does  not  undertake 
private  medical  treatment.  Nevertheless,  such  a  physician 
would  be  under  its  general  guidance  and  supervision  with 
regard  to  the  periodic  examinations,  and  would  cooperate 
effectively  in  giving  them  their  maximum  value. 

Where  a  medical  department  already  exists,  it  is  entirely 
possible  for  the  Institute  to  cooperate,  specializing  as  it  does, 
with  the  assistance  of  the  Hygiene  Reference  Board,  in  the 
work  of  the  Health  Survey  and  the  application  of  the  prin- 
ciples of  personal  hygiene.  No  one  concern  can  group  the 
forces  and  the  scientific  resources  that  are  available  to  the 
Institute,  because  of  its  underlying  altruistic  purposes.  If  the 
Metropolitan  Life  Insurance  Company,  with  assets  of  $386,- 
000,000  and  a  splendidly  equipped  medical  department,  labora- 
tory and  an  extensive  list  of  examiners,  saw  fit  to  pass  this 
work  over  to  the  Institute,  it  must  be  apparent  that  the  aver- 
age business  concern  could  profitably  do  likewise,  rather  than 
attempt  the  work  in  an  individual  way.  The  independent, 
non-partisan  character  of  the  Institute  enables  it  to  command 
the  confidence  of  the  policyholder  and  the  employee,  and  guar- 
antee the  genuineness  of  the  welfare  service  rendered,  a  matter 
of  no  mean  importance — er>pecially  to  the  employer— in  mak- 
ing this  work  effective. 

The  Institute  does  not  advise  that  these  examinations  be 
made  compulsory.  Usually  the  cooperation  of  a  majority 
of  the  employes   can   be  obtained,   if  the   matter   is   properly 

15 


put  before  them.  It  should  be  made  clear  that  the  examina- 
tions are  part  of  the  business  policy  of  the  concern,  but  that 
they  are  likewise  for  the  material  benefit  of  the  employes ; 
that  any  well  grounded  or  serious  objection  will  be  consid- 
ered, but  that  the  total  welfare  of  the  force  and  of  the  business 
requires  that  mere  prejudice  should  not  interfere  with  the  car- 
rying on  of  the  work. 

POSSIBLE  INFLUENCE  ON   NATIONAL  VITALITY. 

It  is  indeed  regrettable  that  we  have  not  yet  reached  the 
millennium.  Almost  daily  we  have  some  evidence  of  our 
remoteness  from  that  happy  state.  As  practical  men,  we  must 
take  conditions  as  we  find  them,  and  do  the  best  we  can  to 
improve  them.  The  time  has  not  yet  come  when  an  individual, 
a  business  institution  or  a  Nation  can  disregard  the  matter 
of  physical  soundness  and  efficiency. 

I  have  referred  to  the  fact  that  our  mortality  statistics  indi- 
cate a  loss  in  vitality  and  an  increasing  death  rate  at  the  middle 
age  periods  of  life,  when  man  should  really  be  at  his  best. 
There  has,  in  fact,  been  an  increase  of  40  per  cent,  during 
the  past  23  years  in  the  death  rate  per  10,000  in  the  United 
States  Registration  Area  from  the  chronic  degenerative  dis- 
eases of  middle  life  and  old  age  and  there  are  signs  of  the 
encroachment  of  these  maladies  on  the  earlier  periods  of  life. 

This  information  is  perhaps  displeasing  to  a  certain  type  of 
optimist,  the  kind  of  an  optimist  who  is  irritated  and  aggrieved 
when  his  bank  notifies  him  that  his  account  is  overdrawn.  The 
other  type  of  optimist,  however,  the  only  type  that  is  of  any 
real  value  in  society,  the  type  that  receives  unpleasant  news 
with  a  firm  countenance  and  immediately  resolves  to  cheer- 
fully anfl  hopefully  apply  a  remedy,  will,  I  am  sure,  receive 
this  particular  jjiece  of   unpleasant  news   in   the   right   spirit. 

The  conditions,  whatever  they  may  be,  that  are  causing  this 
encroachment  of  degenerative  maladies  are  not  to  be  remedied 
by  blunt-eyed  optimism,  but  by  open-eyed  courage  and  deter- 
mined action. 


16 


It  is  true  that  I  have  presented  this  subject  of  health  con- 
servation among  employers  as  a  matter  primarily  of  i)ure 
business  economy,  as  a  measure  that  will  contribute  to  busi- 
ness success.  Every  man  wiio  succeeds  by  energy,  intelli- 
gence and  square  dealing  in  a  business  that  carries  "no  menace 
to  the  people  is  a  public  benefactor.  There  is  no  need  to  apolo- 
gize for  this  work  because  it  is  '"good  business."  On  the  other 
hand,  I  am  confident  that  there  is  no  member  of  this  associa- 
tion who  would  not  derive  a  deep  and  wholesome  satisfaction 
from  the  consciousness  that  the  methods  by  which  he  carries 
on  his  business  are  exerting  a  powerful  influence  in  raising 
the  physical  standard  of  our  race. 

It  is  well  to  avoid  the  mistake  that  Sparta  made  in  concen- 
trating on  mere  physical  excellence,  but  there  is  no  real  rea- 
son why  physical  soundness  and  well-being  should  not  go  hand 
in  hand  v\ith  moral,  intellectual  and  spiritual  growth. 

We  hear  much  in  these  days  of  our  lack  of  preparedness 
for  military  defense,  of  the  need  for  armament,  ships,  a 
trained  soldiery.  We  take  it  for  granted  that  we  have  the 
raw  material  and  that  it  is  of  the  right  quality.  There  is 
danger,  however,  in  taking  too  much  for  granted  when  the 
destiny  of  100  millions  of  people  and  a  splendid  civiliza- 
tion and  industrial  development  are  at  stake.  If  there  are 
forces  in  our  country  that  make  for  physical  decay,  it 
is  well  that  they  should  be  sought  for  and  neutralized.  No 
Nation  can  carry  forward  the  l)anner  of  progress,  enlight- 
ment  and  human  freedom,  whether  in  war  or  peace,  unless 
those  who  march  behind  it  are  of  sound  and  virile  stock. 


17 


LIFE   EXTENSION    INSTITUTE,  Inc. 


Jl   Work  of  Human  Salvage 

ESTABLISHED  by  well-known  leaders  in  the 
field    of    Race    Betterment   who    desire   to 
assist  in  reducing  life-waste  and  to  see  the 
science  of  disease  prevention  put  on  as  large,  solid 
and   enduring   basis    as    curative    medicine.       The 
Institute's  mission  is 

1.  To  teach  you  how  to  a'cot'c/ disease. 

2.  To  advocate  periodic  health  examinations  that 
disease  may  be  detected  in  time  to  give  your 
doctor  a  chance  to  check  or  cure  it. 

3.  To  provide  such  examinations  for  you  at  low 
cost  to  assist  in  establishing  this  life-saving 
practice  amongst  all  our  people. 


DIRECTORS 

Hon.  Wm.  H.  Taft,  Chairman 

Henry  H.  Bowman 

Francis  R.  Cooley 

Robert  W.  deForest 
Prof.  Irving  Fisher 

Eugene  Lyman  Fisk 

E.  R.  L.  Gould 
Harold  A.  Ley 

Elmer  E.  Rittenhouse 

Charles  H.  Sabin 
Frank  A.  VanderHp 


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